^(99)锝-亚甲基二膦酸盐治疗系统性红斑狼疮合并股骨头坏死的临床研究  

Clinical study of ^(99) Technetium-methylenediphosphonate in the treatment of systemic lupus erythematosus complicated with osteonecrosis of the femoral head

作　　者：段聪聪 沈梦佳 侯传云[1] 江超[1] 谢长好[1,2] 王涛 DUAN Congcong;SHEN Mengjia;HOU Chuanyun;JIANG Chao;XIE Changhao;WANG Tao(Department of Rheumatology and Immunology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院风湿免疫科,安徽蚌埠233004 [2]慢性疾病免疫学基础与临床安徽省重点实验室,安徽蚌埠233030

出　　处：《中华全科医学》2023年第8期1275-1278,共4页Chinese Journal of General Practice

基　　金：安徽省自然科学基金项目(2108085MH258);蚌埠医学院科研计划重点项目(2020byzd060)。

摘　　要：目的探究^(99)锝-亚甲基二膦酸盐(^(99)Tc-MDP)治疗系统性红斑狼疮(SLE)合并股骨头坏死(ONFH)的有效性及安全性。方法选取2021年6月-2022年9月蚌埠医学院第一附属医院确诊为SLE合并ONFH(坏死组)及SLE不合并ONFH(对照组)患者共60例。其中坏死组(30例),根据有无使用^(99)Tc-MDP分为常规组(15例)和联合组(15例),对照组为30例;采用ELISA测定联合组与常规组患者治疗1个小疗程前后及对照组血浆骨保护素(OPG)、骨桥蛋白(OPN)浓度并进行比较分析,对联合组及常规组在1个大疗程治疗结束后进行随访,比较患者Harris评分、影像学变化及有无不良反应。结果3组治疗前基线资料差异无统计学意义。1个小疗程治疗后:联合组患者治疗后血浆OPG水平较治疗前OPG水平升高、OPN水平较治疗前降低,差异有统计学意义。1个大疗程治疗后:(1)髋关节功能Harris评分联合组较常规组增加,联合组治疗后较治疗前明显增加,差异有统计学意义;常规组治疗后Harris评分较治疗前差异无统计学意义。(2)^(99)Tc-MDP治疗后影像学评价结果较治疗前无明显进展。(3)3组患者均未出现严重不良反应。结论^(99)Tc-MDP在常规用药基础上治疗SLE合并ONFH临床效果良好,且具有较高的安全性。Objective To investigate the efficacy and safety of ^(99) Technetium-methylenediphosphonate(^(99) Tc-MDP)in the treatment of systemic lupus erythematosus(SLE)complicated with osteonecrosis of the femoral head(ONFH).Methods A total of 60 patients diagnosed with SLE combined with ONFH(necrosis group)and SLE without ONFH(control group)were selected from June 2021 to September 2022 in the First Affiliated Hospital of Bengbu Medical College.Among them,the necrosis group(30 cases)was divided into the conventional group(15 cases)and the combined group(15 cases)according to whether ^(99) Tc-MDP was used.The concentrations of plasma osteoprotegerin(OPG)and osteopontin(OPN)were determined by ELISA before and after a short course of treatment between the combined group and the conventional group,and the control group were compared.Follow-up was conducted after a long course of treatment between the combination group and the conventional group,and the Harris score,imaging changes and adverse reactions were compared.Results There was no significant difference in baseline data between the three groups before treatment.After 1 short course of treatment:compared with before treatment,plasma OPG level increased and OPN level decreased in combination group after treatment,the differences were statistically significant.After 1 course of treatment:(1)The Harris score of hip function in the combined group was increased compared with the conventional group,and was significantly increased after treatment in the combined group compared with before treatment,the difference was statistically significant;There was no significant difference in Harris score between the conventional group after treatment and before treatment.(2)There was no significant improvement in imaging evaluation after ^(99) Tc-MDP treatment.(3)No serious adverse reactions were found in the three groups.Conclusion On the basis of routine medication,^(99) Tc-MDP has good clinical effect and high safety in the treatment of systemic lupus erythematosus complicated with ost

关 键 词：^(99)锝-亚甲基二膦酸盐 系统性红斑狼疮 股骨头坏死 骨保护素 骨桥蛋白 

分 类 号：R593.241[医药卫生—内科学] R681.8[医药卫生—临床医学]